Quote:One of the theories behind the ACA was that competition among insurers on the state exchanges would help bring down costs, but in Iowa, at least, there is now likely to be no competition at all, as Coventry Health Care will be the only insurer left on the exchange if CoOportunity falls completely. Coventry is owned by Aetna, one of the biggest insurers nationally, a Fortune 100 company with an active lobbying presence on Capital Hill. The other company poised to win from from CoOportunity’s collapse is Iowa’s biggest insurer, Wellmark Blue Cross and Blue Shield, which decided not to sell plans on the exchange. That means its plans are not eligible for the federal subsidies provided by the ACA, but Wellmark was nevertheless quick to remind its customers that, “This is unfortunate news and timing for CoOportunity Health policyholders. Wellmark and its authorized agents are here for anyone who has questions about the health insurance options available to them.”

In other words, an ACA initiative has failed in Iowa and Nebraska, and its failure will cause huge disruptions and uncertainties in the lives of many state residents currently covered by CoOportunity. Not only that, but it could mean premium hikes all around. Some claim CoOportunity’s high posted premiums for 2015 sprung from the high concentration of especially sick residents in its risk pools. But if all those customers migrate to Coventry or Wellpoint, they will bring their risks with them, driving up costs for customers of those insurers. And a total CoOportunity collapse would solidify the monopolies large insurers possess in those states, cutting across the very cost control force the ACA hoped to harness.